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Original Article

Evaluation of total serum bilirubin thresholds for discontinuing phototherapy in jaundiced neonates: a randomized study

Nidhi Jain¹  , Ajay Kumar¹

¹Department of Neonatology, Maulana Azad Medical College, New Delhi, India

Correspondence Nidhi Jain ,Email: nidhijain.arain@gmail.com

Received: August 22, 2024; Revised: February 17, 2025   Accepted: February 17, 2025.

Abstract

Background
To evaluate the outcomes of jaundiced neonates using two different total serum bilirubin (TSB) thresholds for discontinuing phototherapy.
Purpose
The study aims to evaluate the outcomes of jaundiced neonates by comparing two different total serum bilirubin (TSB) thresholds for discontinuing phototherapy.
Methods
All consecutive jaundiced neonates in a tertiary care hospital with a gestational age of ≥35 weeks and ≥3 days postnatal age were randomly assigned to two groups.
Results
Eighty neonates were included. The mean ± standard deviation TSB at the time of phototherapy discontinuation was 13.1 ± 2.2 mg/dL in the recommended threshold group and 10.5 ± 2.5 mg/dL in the low threshold group. After discontinuing phototherapy, 17 infants in the recommended threshold group and 21 in the low-threshold group experienced an increased TSB, with three and nine crossing the treatment threshold, respectively. Following the National Institute for Health and Clinical Excellence (NICE) guidelines, there was a 14.3% increase in the reinstitution of treatment, averaging 28.11 h with no reported adverse outcomes.
Conclusion
Discontinuation of phototherapy in neonates led to increased total serum bilirubin levels, with a reinstitution rate of 14.3%. While adherence to the NICE guidelines is important, careful post-treatment monitoring is essential. Incorporating the 2022 American Academy of Pediatrics guidelines into future research could provide a more comprehensive understanding of safe practices in this area.

Keywords :Neonate, Hyperbilirubinemia, Phototherapy discontinuation